In various healthcare settings, patients lying on a bed often have several medical lines attached to their body for various purposes, such as IV drips, electrical monitors, catheters, etc. Management of these medical lines has historically been difficult and time intensive for healthcare professionals. In recent years, the number of these medical lines used per patient has increased, especially with certain populations of critically ill patients. However, no effective solution for addressing this problem has been developed.
The medical lines often get tangled, twisted, knotted, etc. as the patient moves around, the sources of the lines move around, lines are disconnected and reconnected, and new lines are added. This often results in a tangled, disorganized “rat's nest” of lines adjacent to the patient. FIG. 1 shows a mild example of this, though much more tangled, disorganized rat's nests often occur.
This problem presents major and complex challenges for healthcare professionals, such as patient safety, establishment and maintenance of line order, patient mobility, patient transfers, system mobility, physical interferences, time utilization, and visual distress.
The propensity for line tangling increases as the number of lines increases. Many lines include multiple injection ports. Many of the IV tubings connect into the same central line, which with any movement or transfer of the patient creates and expands the chaotic jumble of tubings. Patients coming from the operating room very often have multiple lines that have become tangled in part due to the movement from the operating table to the bed. This also applies to critically ill patient transports to intra-hospital departments such as imaging services (CT, MRI), angiography, and other inter-hospital transfers via helicopter or ambulance.
This all creates an extreme burden on the healthcare team, especially RNs, for providing a constant environment of safety. In many cases, such as upon a return of a patient from the OR to the ICU, such as with post cardiac surgery patients, it is typical for nurses to spend 30-60 minutes in identifying, checking, and detangling lines. It is critical for nurses to be able to have the constant knowledge of which medications are running through which lines, etc. Further, each shift of nurses must be able to validate the individual medication drips, injection ports, tubings, pressure lines, transducers, etc. It is standard for patient safety to be able to follow each line from start to finish—from patient to pump, bag, monitor, etc. Ultimately, this requires additional commitment of time each shift to detangle, validate, and recreate an environment of order, albeit temporary.
In addition, critically ill patients are often turned in bed every two hours and lines easily tangle with turning. Some patients will still have multiple lines, but have improved enough to be able to sit on the edge of the bed or up in a chair at bedside. this movement of the patient can easily create actual and visual disarray and disorder of the lines, despite attempts by nurses to maintain order.
Furthermore, families of patients experience a burden of stress and anxiety having their loved ones in a critical care unit. The visual disarray of the “rat's nest” of medical lines can cause added anxiety, distress and concern for the families regarding confidence in the safety and effectiveness of the care being provided to their loved one.